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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE~ 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered bu]Jde¢ OR the au hori~ed reDresen a ye $ GNATURE OF APPLICAN <br />of a registered builder, - ................................. <br />The work will be performed by e registered builder, <br />Other, <br /> <br /> :L~'~186 MURF~AY LAHE NE <br /> A U ~'t'.ll~ A OF( ?7002 <br />0-~' b'F"~'Oi¢ bTfi~i .............................................................. <br /> <br /> SITE NUMBER: 94-~824~ ~ <br />!~;' H 0 N E',; 26~--75q2 VALUATION= <br /> <br />TYPE: ON-BITE 8EWA~E <br /> <br />PERMIT OR APPLICATION <br /> <br />[iONTRACTOR, <br />FERKE'fT,¢ DICK <br /> <br />I- ll,) E,,, 2(~6-,9,592 <br /> <br /> ITEM <br /> <br /> ~ THIS IS ~OT A PER~Ii~. <br />ALL, NECESSARY ~NFO~HA' <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 34,?;89 <br />EXISTiN6 TANK <br />EXISTING ~RA:~'N F':I:ELD <br />SBPZZC ~ANE ,PWNPEI) <br />'PI;',EV2OUS NO.' ~EDROOMS: <br /> <br /> QUANTITY AMOUNT <br /> :[ $255.00 <br /> <br /> ii~255,, 00 <br /> $0.08 <br /> $ 2 5,'"';.. 80 <br /> <br />i:,~ RECEIPT NO: 54815 <br />:::, TYPE= CK CHECK :1~ 2'30~ <br /> <br /> ~YS'I'EM. <br /> <br /> A REVIEW PROCESS WHERE THE <br /> FHE ~PF'LIC. ANT TO ~SSI.JR~{ THAT <br /> <br />~,.i4AF(K.~,, STD <br /> <br />OFFICE COPY <br /> <br /> <br />